Provider Demographics
NPI:1922450030
Name:KENFIELD, CHRISTINE (CMT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:KENFIELD
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 JONATHAN JCT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-4213
Mailing Address - Country:US
Mailing Address - Phone:757-374-4401
Mailing Address - Fax:
Practice Address - Street 1:1307 JAMESTOWN RD
Practice Address - Street 2:STE 103
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3381
Practice Address - Country:US
Practice Address - Phone:757-229-4161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019010087225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist